Promoting Healthy Lifestyle Choices: Smoking Cessation - Essay Example

SMOKING CESSATION Smoking Cessation Introduction The client is a 15-year old female. She has been smoking since she was the age of 12 years. Her decision to seek my services may have been prompted by the individuals who had succeeded in managing their issues when they sought my assistance. Also, positive referrals may have played a vital role in her seeking my services. The client has a myriad of issues such as; personality crisis and stress. These issues have resulted in an antisocial behaviour of smoking. Personality crisis can easily be managed while stress can also be managed. However, it’s her smoking habit and cessation attempt that draws my attention. The girl needs to be educated and informed about total effects of smoking and why it is important to quit smoking, thus the reason for choosing smoking cessation. Tobacco smoking is a major healthcare issue around the world. In the U.S., Canada and some first world developed nations, it has been identified as the leading cause of preventable mortality. One out of five deaths in the U.S. has been attributed to tobacco. Annually, it is estimated that there are almost 440,000 deaths in the U.S. alone. Individuals inhale tobacco through various means such as pipes, hookahs and kreteks. Smoking poses adverse health consequences such as cancers of the throat, lung, and larynx. Additionally, ailments such as stroke and heart diseases can be attributed to smoking tobacco. The effect is widespread even to non-smokers they inhale the smoke through involuntary smoking. In the U.S. alone, it is approximated that there are close to 7,500 lung cancer deaths annually among non-smokers. The addictive substance in the tobacco is as nicotine. A typical cigarette contains about 13.79 to 22.68 milligrams of nicotine. If inhaled consistently it becomes easily absorbed in the blood and eventually becomes addictive to the consumer. From that point onwards an individual is termed as a tobacco addict. After a number of years, one may choose to quit smoking. However, it is not an easy task. Some individuals experience short-term effects such as; anxiety, difficulty in reacting to situations, craving nicotine substances and increase in weight. In a recent survey, 7 out of 10 smokers in the U.S. indicated that they wanted to quit smoking. For smokers aged 18-24 years, an estimated 5 out of 10 wanted to stop smoking. Quitting is a process that can be undertaken through inpatient or outpatient techniques. Also, various methods have been applied to assist smokers quit. Among them include; counselling, therapies and replacing nicotine with other products (Lewis 2010, Pp. 43). However for my case, the approach I settled on to assist her in smoking cessation is health education and health promotion. Health education is a process where individuals are educated about health issues and make adjustments to their behaviour (Naidoo and Wills 2010, Pp. 50). It involves teaching individuals of causes of ill health and encouraging people to change behaviour and improve healthy living. Health education was popular in the past and included various activities. Those activities are now comprised in a new term known as health promotion. According to the Ottawa Charter for Health Promotion of 1986, Health Promotion is the process of empowering individuals to increase control, over and promote good health practices WHO (2009, Pp. 5). According to Tones in (Naidoo and Wills 2009, Pp. 50), health promotion consists of a planned course of action to promote health and handle illness. It aims at creating social change through regulation, fiscal and economic measures. The technique allows the concerned individuals to have a say in their health issues and to appreciate their view. The Ottawa Charter identified five vital techniques for health promotion. They included a healthy public policy, an environment that supports individual change, empowering personal skills, strengthen community action and reorient health services to the population. According to the Jakarta Declaration on Leading Health Promotion into the 21st century in 1997, five action strategies were identified for health promotions. They include the development of social responsibility for health, additional investments in health sector and inclusive partnerships in health promotion, increased community capacity and improved infrastructure for health promotion (Sharma and Romas 2012, Pp. 9). Application of this approach will be invaluable to my client. Health promotion ensures that the client is well informed about the illness, its causes and its consequences. My client is a female and an adolescent. Therefore, it is important that she is well aware of all the effects of smoking tobacco. In the U.S., it is estimated that more than 3,200 children are smokers. 9 out of 10 start the habit even before they attain the legal age of 18 years. According to the American Lung Association, it estimated that if smoking continues at the same rate, then 1 out of every 13 of todays young smokers will eventually die due to tobacco-related illness. Studies by the CDC indicate that young adults who smoke are potentially destroying their bodies. They also put them in danger of contracting lung infection, retarded growth of the lung and exposure to early cardiovascular diseases (Perkins, Conklin and Levine 2008, Pp. 2). It is also more important that the approach be adopted as the client, in this case, is a female. Surveys posit that the U.S. has an estimate of almost 20 million smokers. It makes them prone to heart attacks, emphysema, lung cancer and stroke. Through this approach, the client will be able to understand clearly and concisely how tobacco affects the body and ones health. It also allows room for the clients to trigger behavioural change and engage in practices that promote good health. Health promotion approach facilitates the understanding that ones health is their responsibility. To achieve the desired results using this approach, I will use the Health Belief Model (HBM). The HBM is by far the most popular (Glanz, Lewis and Rimer 1997, Pp. 31). The model was developed in the 1950s as a fact-finding model of why screening measures, mostly those of tuberculosis, were not successful. The concept of HBM development was that the health pattern is by individual perception about an illness and the methods that can be used to reduce the ailment’s effect. The model has various constructs that constitute it but for the purposes of this case I will examine four of them; Perceived Seriousness The construct identifies a persons belief about the importance of an issue. My client initially started smoking tobacco as a hobby (stress reliever, self-harm reduction and to look cool). At this point, my clients concern was looking relaxed in front of the other kids without realizing the harm that comes with smoking. Individuals including my client believe that nicotine is the mortal danger between smoking and health risks. However, it has been validated that though individuals smoke due to the nicotine in the cigarette, most of them die from other toxic substance in the cigarette. Among them include; carbon (II) oxide, oxides of Nitro, benzene, ammonia, hydrogen cyanide among others. These toxic contents do not contain nicotine. Most of these substances are gases that comprise most of the smoke. Nicotine contributes a minuscule part. However, they are absorbed in the lung after inhaling a puff of smoke. Most individuals fail to realize that the real hazard lies not in the nicotine they so much crave but instead to the significant harmful substances. According to the National Cancer Institute, tobacco smoke is constituted of more than 7,000 chemicals. About 250 are known to be toxic; 69 of them have been isolated and identified as cancer-causing agents (Perkins, Conklin and Levine 2008, Pp. 5). Individuals also perceive that smoking, only, affects the throat and lungs (breathing system). However, it is less known to them that tobacco smoking, apart from increasing ones risk of contracting cancer; it also doubles the risk of a heart attack and other heart related ailments. According to the CDCP, heart diseases contribute to over 100,000 deaths annually, in the United States. If an individual is ailing from other diseases such as diabetes and he or she is smoking then his risk of a cardiovascular ailment doubles. Prescott, Hippe, Schnohr, Ole Hein and Vestbo, 1998 in (Perkins, Conklin and Levine, 2008, Pp. 6) state that females are at a higher risk of cardiovascular disease from smoking. Other diseases that may not be well known to smokers include pneumonia. To a young female, notably my client it is important for her to understand that what is practiced as a pass time activity is more dangerous than it initially seemed. Smoking from such an early age may accelerate the onset of menopause. At the same time, smoking among young girls has been associated with heavy menstrual bleeding and period of dysmenorrhea. My client should also be in the know that smoking from such an age results in them having a difficult time trying to get pregnant naturally or even through in vitro fertilization. My client should also know that, with young smokers, the face tends to acquire wrinkles very fast by decreasing the skin elasticity and connective tissue. Wounds take long to heal and the bone density decreases due to reduced skin blood flow. My client and other young smokers should be aware that smoking is a habit that grows over time to addiction and may result to some of the diseases in the information above. Perceived Personal Risk Personal susceptibility is a perception in promoting adoption of a healthy lifestyle. If individuals perceive that the risk of engaging in some behaviour may have negative consequences then the risk of them engaging in the action reduces. When individuals perceive that they are at risk of contracting a disease, they change their behaviour to reduce chances of contracting the ailment. Young smokers usually run the risk of poor prognosis with asthma. It may result in high hospitalization and healthcare costs Smith and Taylor 2013, Pp. 4). It is related to health behaviour. My client joining an inpatient smoking cessation program can be termed as positive health behaviour. According to Rodham (2010), health psychology is more focused on facilitating adoption of positive health behaviour among addicts. In this case, health psychologists engage with the client and try to enquire why they smoke with the knowledge that they are endangering their existence. Together with the client they work out techniques that promote positive health behaviour towards smoking cessation. There has always been a conflict between professionals belief and what the client perceives. Individuals have insights as to their level of ailment thus know when to seek medical care. The client is aware that if she allows a condition to persist then it may result in a more complex situation (Nash 2014, Pp. 4). Graphic posters, leaflets and brochures have been used in a bid to try and show smokers on the effects of smoking, on various body organs, to achieve this stage. If it is the lungs, they are well drawn in diagrams and every inch of how a single or multiple inhalations affects the lungs. Livers and kidneys are also outlined. Their purpose is to show the smoking individual the effects of a particular behaviour. More so it allows young smokers to measure the risk and trigger behaviour change to the better. Perceived Benefits It is an individuals opinion of the importance of behavioural change in decreasing the risk of developing an illness. Individuals tend to develop positive behaviour change when the risk of contracting the disease is high. Young smokers will quit smoking if they can understand the various health benefits that come with smoking cessation. Perceived benefits play a key role in facilitating adoption of secondary prevention behaviour. The benefits of smoking cessation can be into two broad groups; immediate benefits and Long-term benefits. Immediate benefits include; increased oxygen within blood flow and normal heart rate and blood pressure. Also, lung function returns to normal operation after some time and the coughing and sneezing due to smoking reduces. In addition, smoking cessation may lead to increased sense of smell and improved food appetite and taste. It also significantly reduces the risk of one contracting cardiovascular diseases, cancer and other respiratory diseases. Long-term benefits last almost between 1-2 years. In a survey conducted by the U.S National Health Interview Survey, results indicate that regardless of a smoker’s age, smoke cessation leads to an increase in life expectancy of the individual. Individuals who were early smokers can increase their life expectancy by more than ten years if they can cease smoking between ages 25-34 years. As a young female, my client can maintain her aesthetic and beauty. The wrinkles on the face will not appear if she quits smoking entirely. She will also not experience difficulty in trying to get pregnant. Such perceived benefits can be used to ensure that clients maintain a particular push to try and quit smoking. According to Smith and Taylor (2013), tobacco cessation ensures that individuals experience fewer intra-operative and postoperative complications. Individuals also experience a decreased redo operations and post-operation death due to coronary artery bypass graft. There is of other smoking related illnesses thus significantly increasing survival chances in case of a fatal illness. Perceived Barriers Some individuals harbour a resistance to change. In this construct, the client evaluates the obstacles that may stand in her way towards tobacco cessation. Perceived barriers serve an important role towards behavioural change. For one to adopt the positive health behaviour, the client needs to believe that the benefits far outweigh negative effects had they continued with smoking habits. With that in mind, it triggers an attitude change and prompts adoption of the new behaviour. Some of the challenges my client might encounter include; fear of rejection from social groups and the increased urge to smoke especially after staying clean for some time. Young females are more about personality and influence among their peers. Those that lead in anti-social behaviour are considered to command more respect in the informal social group. Thus, it provides a challenge to individuals such as me to assist these young smokers quit yet they are afraid to lose their influence in the informal social setting. The temptation of going back to old habits is always very high. If the client fails to set standards, the risk of them being drawn back to smoking is also very high. For inpatient services, quitting may itself not prove so much a challenge due to the constant monitoring. However, there is always that instinctive voice that says, ‘just this one time’ if the temptation is high then one may fall right back in. Outpatient individuals are in a more precarious position; this is because other smokers continue with their daily routine. Thus for this approach, high discipline conduct should be ultimately high if there are any chances of success in smoke cessation. Modifying Variables The four constructs are then modified by various variables such as culture, experience, education level and motivation. For my female client, past experiences, in this case, may be respiratory diseases such as pneumonia or heavy menstruation blood. For her, she can draw on that experience to trigger behaviour change and develop positive health behaviour. For instance, balancing calories to manage weight reduces her risk of heart attacks and other cardiovascular diseases. Additionally, since she is an in-patient, it may facilitate increased vegetable and fruit intake (DeBruyne and Pinna, 2013). Cue for Action The HBM also suggest that healthy behaviour can also be influenced by cues to action. Cues to action are other people or external events that contribute to behaviour change among smokers. In this case, they are the external parties that play a significant role in assist in the smoke cessation of the clients. They include health warnings on products, media campaigns, media reports, family members and counselling from others. For instance, it is a regulation that every pack of cigarette should bear a health warning, ‘smoking is harmful to your health. Though the message may not be effective to an addict, at least it may be a preventive measure for individuals who wish to take up smoking as a hobby. TV and Radio advertisements on the ill effects of smoking may also contribute to positive health behaviour change and eventually smoking cessation. For clients such as mine, if they are about the negative effects that come with smoking towards reproductive health, then as an aspiring future mother, it may act as a trigger to smoking cessation. Self-Efficacy Self-efficacy was introduced to HBM in 1988 (Becker and Rosenstock 1994 Pp. 137). It is the belief in an individual’s ability to do something. Individuals undertake a task because they are positive they have the capability to complete it effectively. If an individual sees the benefit of doing something, but then thinks he or she is not capable then chances are that the activity will not be undertaken. Self-efficacy forms the strongest base of smoke cessation. It is in ones sheer will power and belief that he or she can quit smoking if they wanted. It is important to note that despite the media campaigns in education and health promotion, if the individual lacks the sheer willpower to commit to the task and process of quitting the smoking the habit, then all efforts are in vain. For my client, she must rise above, the fear of rejection from her peer groups and the fact that all she was doing was harming her body in order for the program to succeed. The drive must first be innate before external assistance can be exerted to aid her in smoking cessation. Smoking Cessation Activities Smoking cessation is mostly influenced by behavioural change theories such as the HBM. It is a complex process implemented through various interventions. Alternative means of delivery have been created to ensure that the program reaches a lot of individuals. Individuals most often chose their preferred mode of delivery. The most popular among individuals who seek smoke cessation include brief advice, individual counselling about ones behaviour, group behaviour therapy sessions, self-help materials and phone counselling. In this case, the best-suited technique for the client is Brief Intervention. The technique has been used widely by professionals and more so General Practitioners (GP). The technique is acclaimed as close to 3 out of 100 smokers eventually cease the habit in about six months. The technique is advocated because close to 40% of smokers who hear it from a GP attempt to quit smoking. As a GP, I utilize the 5As approach that is common in many countries including the U.S. By using this approach the GP ‘Asks’ the patient if they smoke. The GP then ‘Assesses’ the individuals willingness to cease the habit. The GP then offers ‘Advice’ on why it is important for the client to quit smoking tobacco. Then he or she offers ‘Assistance’ in the form of counselling or refers them to a professional who provides behavioural support. Often the brief advice takes about 5-10 minutes in a series of consultative meetings. With my client, providing information that was previously not known to her will most likely produce a favourable outcome (Roberts, Kerr and Smith 2013, 82). With this method, I intend to take the client through the deep lying facts about smoking. I believe that if she is opened up to detailed information of the hazardous contents of a cigarette and its health consequence, then she might quit the habit. Research shows that individuals engage in social activities without knowing the real reason as to why. If she is smoking due to stress then as a GP, I should identify the reasons for the stress and try and address positive strategies to deal with the stress. To ensure that the client does not deviate from the routine, it is important only to provide a cigarette to them only if it’s on the program. Visitors should also be screened to ensure they do not smuggle cigarettes to the patient. The client will develop her schedule on days to smoke and how to eventually wind up. The process is expected to pick up slow, but progress will be noted. Mass media campaigns (posters and pamphlets) can provide knowledge about the negative consequences of smoking, the potential benefits of stopping and support measures towards cessation. Use of mass media can also be used to facilitate the delivery of smoking cessation services. In a bid to encourage people to stop the vice, contests have been developed in some countries. In the case of the young girl, follow up is more appropriate measure. As a general measure, consistent follow up has been identified to result in an estimated 20% smoking cessation (WHO 2004, Pp. 8). Conclusion Health promotion is a proved framework that is used to instil positive health behaviour among individuals. Its inclusive nature in such a manner that both professionals and the clients contribute to tackling of the problem makes it ideal to deal with issues such as smoking cessation. The program educates wholly of the components of a cigarette, its toxins, and negative consequences to a smokers health. To this effect, the client is well informed to make a decision of whether she intends to quit smoking. It is important also to note the importance of the Health Belief Model, its combination with the health promotion provides a wealth of information that facilitates an individual’s decision on smoking cessation. Reference List Becker, M., & Rosenstock, I.M. (1994). Compliance with Medical Advice: Healthcare and Human Behavior. London: Academic Press. Pp.137. DeBruyne L., & Pinna K., (2013) Nutrition for Health and Healthcare. Cengage Learning Glanz, K., Lewis E.M., & Rimer B.K., (1997). Health Behaviour and Health Education: Theory Research and Practice. San Francisco: Jossey Bass Publishers. Pp.31 Lewis, K. E. (2010). Smoking cessation. Oxford, Oxford University Press. Pp.43 Naidoo, J., & Wills, J. (2009). Foundations for health promotion. Edinburgh, Baillière Tindall/Elsevier. http://site.ebrary.com/id/10511722. Pp.50 Nash, M. (2014). Physical health and well-being in mental health nursing. Maidenhead, McGraw-Hill/Open University. Pp. 4 Perkins A.K., Conklin A.C., & Levine D.M., (2008), Cognitive-behavioral Therapy for Smoking Cessation: A Practical Guidebook to the most Effective Treatments. Taylor & Francis. Pp. 2- Roberts J.N., Kerr M.S., & Smith S.M., (2013). Behavioral Interventions Associated with Smoking Cessation in Treatment of Tobacco Use. Libertas Academica Ltd Pp. 2 Rodham K. (2010). Health Psychology. Palgrave Macmillan Sharma, M., & Romas, J. A. (2012). Theoretical foundations of health education and health promotion. Sudbury, MA, Jones & Bartlett Learning. Pp. 9 Smith M. P., & Taylor C.B. (2013). Implementing an Inpatient Smoking Cessation Program. Psychology Press Pp. 4 WHO (2004). WHO European Strategy for Smoking Cessation Policy. Pp. 8 WHO (2009). Milestones in Health Promotion: Statements from Global Conferences. WHO Press Pp. 5 Read More